Bariatric Procedure Trends
Q: Is bariatric procedure growth weakening, and how does it affect guidance?
A: Bariatric procedures have decelerated to be flat year-over-year, and it's uncertain whether the trend will worsen or improve. The low end of our guidance assumes further weakness in bariatric procedures, while the high end assumes flat to slightly positive growth.

da Vinci 5 Supply Constraints
Q: When will supply constraints for da Vinci 5 be resolved and trigger full launch?
A: We are optimizing the supply chain and ensuring quality, which will continue through all of 2024 and into early 2025. Incorporating customer feedback and adding feature enhancements are also part of our plan. We don't expect significant changes to this timeline.

China Pricing Pressure
Q: Is lower pricing in China temporary or permanent, and what's the competitive situation?
A: Lower pricing in China is primarily due to competition from domestic robotic players. We have introduced a domestically manufactured Xi system, allowing us to participate in tenders requiring local production and to segment on price. Pricing pressure is expected to continue due to the competitive environment.

System Placement Outlook
Q: Could system placements be higher in 2024 despite previous expectations?
A: We expect trade-in volumes to decline in 2024 due to limited supply of da Vinci 5 and a smaller remaining installed base of third-generation Si systems. Overall system placements may be choppy as customers might choose to wait for da Vinci 5. We generally do not provide specific guidance on system placements.

Procedure Volume Growth
Q: What's driving the strong procedure volume, and is it sustainable?
A: We saw particular strength in the U.S. and U.K., with continued growth in procedures beyond urology, including cancer procedures like colorectal, thoracic, and hysterectomy. Early-stage growth in benign procedures in international markets also contributed. While we raised guidance slightly, we're monitoring sustainability carefully.

da Vinci 5 Features and New Indications
Q: How might da Vinci 5's features allow for new procedures?
A: da Vinci 5 offers better imaging, precision, and high performance, enabling subtle and fine surgical motions. While current indications largely mirror those of Xi and X systems, we're evaluating additional clinical indications that may require FDA discussions.

Ion Growth and Supply Issues
Q: Is Ion's growth sustainable despite supply challenges?
A: We experienced a partial recovery this quarter but haven't fully resolved catheter and vision probe supply issues. There's a backlog pending supply stabilization. Growth is driven by placements in both existing and new accounts, including greenfield opportunities.

Force Feedback Instruments Impact
Q: Feedback on force feedback instruments and plans to expand the portfolio?
A: Clinicians are exploring the benefits of force feedback instruments, which have sensitive sensors reporting tissue contact forces. Using force reflection, surgeons can reduce the force applied to tissue, potentially improving patient outcomes. We aim to make these instruments robust at scale before expanding the portfolio.

SP Platform in Europe and U.S. Implications
Q: How does SP's indication expansion in Europe affect the U.S. market approach?
A: Early uptake and excitement in Europe are encouraging. Success in markets like Korea and Japan is informing our approach. We have submitted for additional indications in the U.S. and are conducting IDE trials, which may accelerate U.S. indications over time.